氨甲环酸治疗产后出血......及其他研究

The BMJ Pub Date : 2024-11-14 DOI:10.1136/bmj.q2483

Ann Robinson

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引用次数: 0

摘要

安-罗宾逊（Ann Robinson）回顾最新研究产后出血每年导致约 7 万名妇女死亡。自2017年WOMAN试验结果公布以来，产后三小时内静脉注射氨甲环酸一直是首选治疗方法。它能否预防产后出血仍不清楚。柳叶刀》杂志上的两项重要研究提供了不同的视角。在中低收入国家进行的 WOMAN-2 试验发现，与安慰剂（7% 对 6.6%）相比，对于中度或重度贫血的产妇，在脐带夹闭后 15 分钟内给予 1 克氨甲环酸并不能降低临床诊断的产后出血（失血量大于 500 毫升）风险，也不会影响产妇死亡率或不良事件。第二项研究是对五项试验进行的大型荟萃分析，其中包括来自高收入国家、美国、加拿大和英国的研究。

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Tranexamic acid for postpartum bleeding … and other research

Ann Robinson reviews the latest research Postpartum haemorrhage kills around 70 000 women a year. Since the results of the WOMAN trial in 2017, intravenous tranexamic acid given within three hours of birth has been the treatment of choice. Whether it can prevent postpartum haemorrhage remains unclear. Two important studies in the Lancet offer different perspectives. The WOMAN-2 trial, conducted in low and middle income countries, found that, in women with moderate or severe anaemia, giving 1 g tranexamic acid within 15 minutes of the umbilical cord being clamped did not reduce the risk of clinically diagnosed postpartum haemorrhage (>500 mL blood loss) compared with placebo (7% v 6.6%) and did not affect maternal mortality or adverse events. The second study was a large meta-analysis of five trials including studies from high income countries, …

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The BMJ

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